St. John’s wort is a wild plant that has several purported medicinal properties. It is best known for its ability to help alleviate symptoms of mild to moderate depression. While It is not an FDA approved medication, it is widely available as a natural herbal supplement, sold both online and in stores.1,2,3,4
What Is St. John’s Wort?
St. John’s wort, usually referred to as a weed, has most commonly been used as an antidepressant supplement for those living with symptoms of depression.3,4 Other research suggests that the plant may possibly have antiviral, antibacterial, and anticancer properties.1,5 St. John’s wort may also be known as goatweed, amber, hardhay, kamath, or tipton weed.3
This plant has been used for many centuries to treat both psychological and physical health conditions. Typically, the flower, stem, and leaves of the plant are ground to be used in capsules or tablets. Less commonly, the plant may also be used to create teas, tinctures, or salves for oral and topical applications. It is believed that St. John’s wort gets its potency from two chemical compounds, hypericin and hyperforin.1,2,3,4,5,6,7
St. John’s Wort Uses
St. John’s wort has been utilized by different cultures across the globe for years. Historically, salves made from the plant were applied to wounds for the prevention of infection, treating snake bites, or quickening the healing process.1,7 Those suffering from lung and kidney problems, fevers, and a variety of ‘nervous’ disorders–impacting someone’s mood or sleep patterns– were given its extract to help combat symptoms. In the more distant past, many believed the weed offered spiritual protection and was often used to exorcize demons.7
Today, St. John’s wort is primarily used as a holistic alternative to prescription antidepressants. In some countries such as Germany, it may be prescribed by health professionals as a frontline treatment for depression.4 In the US, it is sold as a natural supplement for the treatment of a wide range of conditions and can be found in most drug stores or pharmacies.1
How Does St. John’s Wort Work?
Researchers believe that St. John’s wort obtains its healing and antidepressant qualities from two organic compounds that naturally occur within the plant. These compounds, hypericin and hyperforin, act as neurotransmitter reuptake inhibitors in the brain to lessen a condition’s negative symptoms.1,2,4,8
Hypericin and hyperforin are believed to help increase levels of the following neurochemicals in the brain:
- Serotonin: A brain chemical that helps stabilize mood, sleep, and reduce depression
- Dopamine: A brain chemical linked to mood, motivation, movement, and pleasure
- Norepinephrine: A brain chemical linked to focus, energy, and alertness
- GABA: A brain chemical that helps regulate the nervous system and reduce anxiety
How Long Does It Take for St. John’s Wort to Work?
Like most other antidepressants, St. John’s wort will not have an immediate impact on a person’s mood. According to research, it can take between 2-6 weeks for someone to notice improved symptoms of depression.2,3 If you don’t observe any improvements after this time frame, St. John’s wort may not be an effective solution for you.
St. John’s Wort for Depression
In several studies, patients who frequently used St. John’s wort were shown to experience similar depression symptom improvement to those who were prescribed SSRIs and SNRIs.1,2,4 Additionally, St. John’s wort may be a preferred alternative treatment for those who can’t tolerate traditional medication. When taken daily, people observed distinguishable positive changes in the management of their symptoms.2,4
Benefits of St. John’s Wort
When taken in proper doses and used correctly, St. John’s wort can prove effective in the treatment of many conditions, with little to no side effects. For those who experience severe negative reactions to traditional SSRIs, this alternative treatment can be beneficial in conjunction with their treatment plan.1,2,3,4,5,9
St. John’s wort may result in the improved symptoms of:
- Mild to moderate major depressive disorder
- Obsessive compulsive disorder (OCD)
- Generalized anxiety disorder (GAD)
- Premenstrual syndrome
While these claims have not been fully substantiated, some researchers suggest St. John’s wort may also have:
- Antiviral and antibacterial properties
- Pain relieving properties (for menstrual cramps or nerve pain)
- Mild tranquilizing properties (for sleep or anxiety disorders)
- Astringent properties (drawing water from the skin)
- Anti-inflammatory qualities
- Anti-cancer properties
St. John’s Wort Side Effects
While St. John’s wort is generally considered to be safe, like any supplement, usage poses the potential for adverse reactions in patients. Regardless, side effects are typically mild in nature, but vary from person to person.1,2,3,4,9 Before taking St. John’s wort, you should consult your licensed medical provider to weigh out its potential risks and benefits.
The most commonly reported side effects from St. John’s wort include:
- Increased sensitivity to sunlight
- Becoming more susceptible to sunburns
- Increased anxiety or restlessness
- Fatigue
- Dry mouth
- Headache
- Upset stomach
Is St. John’s Wort Safe?
One of the most serious risks associated with St. John’s wort is the chance of the plant negatively interacting with other medications. Some research suggests it may reduce the effectiveness of oral contraceptives. Additionally, experts warn that combining certain medications with St. John’s wort can lead to less than favorable side effects.1,3,5
You should consult with your doctor before beginning a St. John’s wort dosage if you currently take:
- Oral contraceptives (i.e. birth control pills)
- Antiepileptic medications (i.e. seizure meds or anticonvulsants)
- Blood thinners
- Cancer or chemotherapy drugs
- Medications provided after organ transplant
- Antiviral medications (i.e. for HIV management)
- Other prescribed antidepressants – as it is possible to have adverse reactions to taking multiple agents that increase serotonin levels
St. John’s Wort Dosage
In the treatment of depression, the most common daily prescription of St. John’s wort is 900 mg, which can be broken down into 2-3 dosages.2 However, some studies have experimented with both 500mg and 1800mg doses; each dosage appeared to be well-tolerated by participants.2,3,9 Your medical practitioner will work with you to determine which level is suitable for you.
Questions to Ask Your Health Team About St. John’s Wort
If you are considering supplementing traditional medications with St. John’s wort, it’s important to consult your primary care doctor, psychiatrist, or other prescriber before doing so. Be sure to share your reasons for wanting to try the supplement. Your healthcare team will be able to determine if the plant is a viable and healthy option to pursue. Make sure to disclose any prescribed or natural medications that you’re already taking to reduce the risk of adverse interactions or side effects.
Some questions to ask your provider about St. John’s wort include:
- What should I expect when I begin a St. John’s wort regiment?
- Are you aware of any potential adverse effects of St. John’s wort?
- Will this supplement interact negatively with any of my other medications?
Final Thoughts
St. John’s wort is a natural herbal supplement that is commonly used as an alternative treatment for mild to moderate depression. However, this supplement should not be used to treat severe depression or bipolar disorder, as further research is needed to determine its effectiveness in these circumstances.1,2,3,4 It’s important to note that even natural supplements can lead to adverse effects for some. Speaking with a doctor, psychiatrist, or other healthcare professional before starting any natural or alternative treatment is recommended.
For Further Reading
- St. John’s Wort – Mayo Clinic
- The Best Natural Supplements for Anxiety & Depression – Consumer Health Digest
- Lifestyle Medicine for Depression – Research Gate
